Oral carbohydrate rinse: placebo or beneficial?

Nutritional approaches to counter performance constraints in high-level sports competition

New Findings

What is the topic of this review?

The nutritional strategies that athletes use during competition events to optimize performance and the reasons they use them.

What advances does it highlight?

A range of nutritional strategies can be used by competitive athletes, alone or in combination, to address various event‐specific factors that constrain event performance. Evidence for such practices is constantly evolving but must be combined with understanding of the complexities of real‐life sport for optimal implementation.

Abstract

High‐performance athletes share a common goal despite the unique nature of their sport: to pace or manage their performance to achieve the highest sustainable outputs over the duration of the event. Periodic or sustained decline in the optimal performance of event tasks, involves an interplay between central and peripheral phenomena that can often be reduced or delayed in onset by nutritional strategies. Contemporary nutrition practices undertaken before, during or between events include strategies to ensure the availability of limited muscle fuel stores. This includes creatine supplementation to increase muscle phosphocreatine content and consideration of the type, amount and timing of dietary carbohydrate intake to optimize muscle and liver glycogen stores or to provide additional exogenous substrate. Although there is interest in ketogenic low‐carbohydrate high‐fat diets and exogenous ketone supplements to provide alternative fuels to spare muscle carbohydrate use, present evidence suggests a limited utility of these strategies. Mouth sensing of a range of food tastants (e.g., carbohydrate, quinine, menthol, caffeine, fluid, acetic acid) may provide a central nervous system derived boost to sports performance. Finally, despite decades of research on hypohydration and exercise capacity, there is still contention around their effect on sports performance and the best guidance around hydration for sporting events. A unifying model proposes that some scenarios require personalized fluid plans while others might be managed by an ad hoc approach (ad libitum or thirst‐driven drinking) to fluid intake.

Single and Serial Carbohydrate Mouth Rinsing Do Not Improve Yo-Yo Intermittent Recovery Test Performance in Soccer Players

Carbohydrate (CHO) mouth rinsing seems to improve performance in exercises lasting 30-60 min. However, its effects on intermittent exercise are unclear. It is also unknown whether serial CHO mouth rinses can promote additional ergogenic effects when compared with a single mouth rinse. The aim of this study was to evaluate the effect of single and serial CHO mouth rinses on Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IR1) performance in soccer players. In a randomized, crossover, double-blind, placebo-controlled design, 12 male (18.9 ± 0.5 years) soccer players performed eight serial mouth rinses under three different conditions: placebo solution only (noncaloric juice), seven placebo mouth rinses plus a single CHO mouth rinse (8% maltodextrin), or eight CHO mouth rinses (8-CHO). Following the final mouth rinse, individuals performed the Yo-Yo IR1 test to evaluate the maximal aerobic endurance performance measured via total distance covered. There were no differences in Yo-Yo IR1 performance between sessions (p = .32; single CHO mouth rinse (8% maltodextrin): 1,198 ± 289 m, eight CHO mouth rinses: 1,256 ± 253 m, placebo: 1,086 ± 284 m). In conclusion, single and serial CHO mouth rinsing did not improve performance during the Yo-Yo IR1 for soccer players. These data suggest that CHO mouth rinsing is not an effective ergogenic strategy for intermittent exercise performance irrespective of the number of rinses.

Effect of Carbohydrate Mouth Rinse on Resistance Exercise Performance

Green, MS, Kimmel, CS, Martin, TD, Mouser, JG, and Brune, MP. Effect of carbohydrate mouth rinse on resistance exercise performance. J Strength Cond Res XX(X): 000-000, 2020-A carbohydrate mouth rinse (CMR) has been shown to enhance short duration endurance performance and raises the possibility that a similar strategy could improve performance during resistance exercise. Eighteen male and female (N = 36) resistance trained subjects (mean values ± SD; age: 21.5 ± 1.6 years, height: 1.72 ± 0.09 m, body mass: 72.8 ± 13.4 kg, and body fat: 16.7 ± 5.8%) performed 3 experimental visits during which bench press resistance exercise (4 × 10 repetitions at 65% of 1 repetition maximum [1RM] with 120 seconds recovery) and repetitions to failure at 60% 1RM were performed. Subjects rinsed 25 ml of water (WAT), noncaloric placebo (PLA), or 6.4% maltodextrin (CHO) solution for 10 seconds during exercise in a crossover, counter-balanced manner. Rating of perceived exertion (RPE), pleasure-displeasure (FS), number of repetitions to fatigue (REPS), and postexercise blood glucose (GLU) and lactate (LA) were measured. Compared with WAT (17.7 ± 0.8), PLA (19.0 ± 0.7; p = 0.025), and CHO (18.7 ± 0.8; p = 0.039) resulted in higher REPS, with no difference between PLA and CHO treatments (p = 0.310). Rating of perceived exertion progressively increased each set (p < 0.0001), but was not affected by treatment (p = 0.897). Pleasure-displeasure declined during recovery from sets 3 and 4 (p < 0.05) but was also not affected by treatment (p = 0.692). Postexercise GLU (p = 0.103) and LA (p = 0.620) were not different between treatments. Although a placebo effect was present for REPS, this study failed to detect an effect of CMR on REPS, RPE, FS, GLU, or LA on upper-body resistance exercise.

Effects of Carbohydrate Mouth Rinse on Cycling Time Trial Performance: A Systematic Review and Meta-Analysis

BACKGROUND

Despite the growing number of studies reporting carbohydrate mouth rinse effects on endurance performance, no systematic and meta-analysis review has been conducted to elucidate the level of evidence of carbohydrate mouth rinse effects on cycling trial performance such as time-, work-, and distance-based trials.

OBJECTIVES

The objective of this study were to establish the effect of a carbohydrate mouth rinse on cycling performance outcomes such as mean power output and time to complete a trial, together with the risk of bias in the cycling-carbohydrate mouth rinse literature.

METHODS

We systematically reviewed randomized placebo-controlled trials that assessed carbohydrate mouth rinse effects on mean power output and time to complete the trial. A random-effects meta-analysis assessed the standardized mean difference between carbohydrate and placebo mouth rinses.

RESULTS

Thirteen studies (16 trials) were qualitatively (systematic review) and quantitatively (meta-analysis) analyzed with regard to mean power output (n = 175) and time to complete the trial (n = 151). Overall, the reviewed studies showed a low risk of bias and homogeneous results for mean power output (I² = 0%) and time to complete the trial (I² = 0%). When compared with placebo, the carbohydrate mouth rinse improved mean power output (standardized mean difference = 0.25; 95% confidence interval 0.04-0.46; p = 0.02), but not the time to complete the trial (standardized mean difference = - 0.13; 95% confidence interval - 0.36 to 0.10; p = 0.25).

CONCLUSION

The present systematic and meta-analytic review supports the notion that a carbohydrate mouth rinse has the potential to increase mean power output in cycling trials, despite showing no superiority over placebo in improving time to complete the trials.

Incorporating methods and findings from neuroscience to better understand placebo and nocebo effects in sport

Placebo and nocebo effects are a factor in sports performance. However, the majority of published studies in sport science are descriptive and speculative regarding mechanisms. It is therefore not unreasonable for the sceptic to argue that placebo and nocebo effects in sport are illusory, and might be better explained by variations in phenomena such as motivation. It is likely that, in sport at least, placebo and nocebo effects will remain in this empirical grey area until researchers provide stronger mechanistic evidence. Recent research in neuroscience has identified a number of consistent, discrete and interacting neurobiological and physiological pathways associated with placebo and nocebo effects, with many studies reporting data of potential interest to sport scientists, for example relating to pain, fatigue and motor control. Findings suggest that placebos and nocebos result in activity of the opioid, endocannabinoid and dopamine neurotransmitter systems, brain regions including the motor cortex and striatum, and measureable effects on the autonomic nervous system. Many studies have demonstrated that placebo and nocebo effects associated with a treatment, for example an inert treatment presented as an analgesic or stimulant, exhibit mechanisms similar or identical to the verum or true treatment. Such findings suggest the possibility of a wide range of distinct placebo and nocebo mechanisms that might influence sports performance. In the present paper, we present some of the findings from neuroscience. Focussing on fatigue as an outcome and caffeine as vehicle, we propose three approaches that researchers in sport might incorporate in their studies in order to better elucidate mechanisms of placebo/nocebo effects on performance.

No Improvement in Running Time to Exhaustion at 100% VO2max in Recreationally Active Male Runners With a Preexercise Single-Carbohydrate Mouth Rinse

BACKGROUND

Carbohydrate (CHO) mouth rinse has been used as an ergogenic strategy due to its central effect; however, the effects of this intervention during short-duration high-intensity exercises are not fully understood.

PURPOSE

To investigate the effect of CHO mouth rinse on time to exhaustion in a short-duration high-intensity exercise performed on a treadmill.

METHODS

A randomized double-blind, placebo-controlled, crossover study was conducted with 10 (24.1 [4.3] y) recreationally active male runners. The protocol consisted of a warm-up at 65% of VO2max for 5 min followed by 3 min passive rest. At the end of this rest period, the individuals performed their mouth rinse either with CHO (maltodextrin, 6%) or with placebo (industrialized noncaloric juice with the same taste). Immediately after mouth rinse, the subjects ran at velocity equivalent to 100% of individual VO2max until voluntary exhaustion. The perceived effort was obtained through a Borg scale. Blood lactate was quantified before and after the protocol, and heart rate was evaluated during the protocol.

RESULTS

No difference was found (P = .90) in time to exhaustion between placebo (193.9 [46.5] s) and CHO mouth rinse (195.1 [51.8] s). Blood lactate, heart rate, and perception of effort increased in both groups, but with no differences (all variables, P > .05) between groups.

CONCLUSION

The findings showed that a preexercise single-CHO mouth rinse was ineffective to improve running time to exhaustion at velocity equivalent to 100% VO2max on a treadmill in recreationally active male runners.

Effect of Carbohydrate Mouth Rinse on Performance after Prolonged Submaximal Cycling

Previous studies have shown improved shorter duration (∼1 h) performance with carbohydrate (CHO) mouth rinsing (WASH), especially in overnight fasted/non-fuelled subjects.

PURPOSE

To determine the effect of WASH on cycling time trial (TT) performance and muscle activity (EMG) after 2 h of submaximal cycling while receiving CHO (FED).

METHODS

In a double-blind, placebo-controlled crossover design, 10 well-trained males cyclists (V˙O2max: 65 mL·kg·min) completed two experimental trials. Each trial consisted of a standardized pretrial snack (2 h prior) followed by 120 min of steady-state (SS) cycling (∼60% V˙O2max) followed by an approximately 30-min TT, randomized as follows: 1) 30 g CHO·h during SS + WASH during TT (every 20% of TT) (FEDWASH); 2) 30 g CHO·h during SS + placebo (PLA) wash during TT (FEDPLA).

RESULTS

Although FEDWASH was not significantly different than FEDPLA (P = 0.51), there was a 1.7% (90% confidence interval, +6.4% to -3.2%; ES, 0.21) decrease in TT time (35 s) for FEDWASH compared with FEDPLA, with qualitative probabilities of a 60% positive and 23% trivial outcome. For EMG, soleus showed significant increase, whereas medial gastrocnemius showed significant decrease in muscle recruitment from the beginning 20% TT segment to the last 20% only in the FEDPLA condition, which coincided with a slower (P = 0.01) last 20% of the TT in FEDPLA versus FEDWASH.

CONCLUSIONS

Contrary to previous studies, this investigation utilized conditions of high ecological validity including a pretrial snack and CHO during SS. Significant changes in muscle recruitment and time over the last 20% of the TT, along with an average 1.7% improvement in TT time, suggest CHO mouth rinse helps maintain power output late in TT compared with placebo. Although marginal gains were achieved with a CHO mouth rinse (35 s), small performance effects can have significant outcomes in real-world competitions.

Brain Responses to Anticipation and Consumption of Beer with and without Alcohol

Beer is a popular alcoholic beverage worldwide. Nonalcoholic beer (NA-beer) is increasingly marketed. Brain responses to beer and NA-beer have not been compared. It could be that the flavor of beer constitutes a conditioned stimulus associated with alcohol reward. Therefore, we investigated whether oral exposure to NA-beer with or without alcohol elicits similar brain responses in reward-related areas in a context where regular alcoholic beer is expected. Healthy men (n = 21) who were regular beer drinkers were scanned using functional MRI. Participants were exposed to word cues signaling delivery of a 10-mL sip of chilled beer or carbonated water (control) and subsequent sips of NA-beer with or without alcohol or water (control). Beer alcohol content was not signaled. The beer cue elicited less activation than the control cue in the primary visual cortex, supplementary motor area (reward-related region) and bilateral inferior frontal gyrus/frontal operculum. During tasting, there were no significant differences between the 2 beers. Taste activation after swallowing was significantly greater for alcoholic than for NA-beer in the inferior frontal gyrus/anterior insula and dorsal prefrontal cortex (superior frontal gyrus). This appears to be due to sensory stimulation by ethanol rather than reward processing. In conclusion, we found no differences in acute brain reward upon consumption of NA-beer with and without alcohol, when presented in a context where regular alcoholic beer is expected. This suggests that in regular consumers, beer flavor rather than the presence of alcohol is the main driver of the consumption experience.

Cognitive Performance Enhancement Induced by Caffeine, Carbohydrate and Guarana Mouth Rinsing during Submaximal Exercise

The aim of this study was to investigate the influence of serial mouth rinsing (MR) with nutritional supplements on cognitive performance (i.e., cognitive control and time perception) during a 40-min submaximal exercise. Twenty-four participants completed 4 counterbalanced experimental sessions, during which they performed MR with either placebo (PL), carbohydrate (CHO: 1.6 g/25 mL), guarana complex (GUAc: 0.4 g/25 mL) or caffeine (CAF: 67 mg/25 mL) before and twice during exercise. The present study provided some important new insights regarding the specific changes in cognitive performance induced by nutritional supplements. The main results were: (1) CHO, CAF and GUA MR likely led participants to improve temporal performance; (2) CAF MR likely improved cognitive control; and (3) CHO MR led to a likely decrease in subjective perception of effort at the end of the exercise compared to PL, GUA and CAF. Moreover, results have shown that performing 40-min submaximal exercise enhances information processing in terms of both speed and accuracy, improves temporal performance and does not alter cognitive control. The present study opens up new perspectives regarding the use of MR to optimize cognitive performance during physical exercise.

Carbohydrate mouth rinse improves morning high-intensity exercise performance

Oral carbohydrate (CHO) rinsing has been demonstrated to provide beneficial effects on exercise performance of durations of up to one hour. The aim of the present study was to investigate the effects of CHO mouth rinsing on morning high-intensity exercise performance. Following institutional ethical approval and familiarisation, 12 healthy males (mean ± SD age: 23 ± 3 years, height: 175.5 ± 7.4 cm, body mass: 75.4 ± 7.5 kg) participated in this study. Countermovement jump (CMJ) height, isometric mid-thigh pull peak force, 10 m sprint time and bench press and back squat repetitions to failure were assessed following CHO and placebo (PLA) rinsing or a control condition (CON). All testing took place at 07:30 following an 11 hour overnight fast. Performance of CMJ height (CHO: 39 ± 7 cm; PLA: 38 ± 7 cm; CON: 36 ± 6 cm; P = .003, [Formula: see text] = 0.40), 10 m sprint time (CHO: 1.78 ± 0.07 s; PLA: 1.81 ± 0.07 s; CON: 1.85 ± 0.05 s; P = .001, [Formula: see text] = 0.47), the number of bench press (CHO: 25 ± 3; PLA: 24 ± 4; CON: 22 ± 4; P < .001, [Formula: see text] = 0.55) and squat (CHO: 31 ± 4; PLA: 29 ± 5; CON: 26 ± 6; P < .001, [Formula: see text] = 0.70) repetitions and mean felt arousal (CHO: 5 ± 1; PLA: 4 ± 0; CON: 4 ± 0; P = .009, [Formula: see text] = 0.25) improved following CHO rinsing. However, isometric mid-thigh pull peak force was unchanged (CHO: 2262 ± 288 N; PLA: 2236 ± 354 N; CON: 2212 ± 321 N; P = .368, [Formula: see text] = 0.08). These results suggest that oral CHO rinsing solution significantly improved the morning performance of CMJ height, 10 m sprint times, bench press and squat repetitions to failure and felt arousal, although peak force during an isometric mid-thigh pull, rating of perceived exertion and heart rate were unaffected.

Nutrition and Supplementation in Soccer

Contemporary elite soccer features increased physical demands during match-play, as well as a larger number of matches per season. Now more than ever, aspects related to performance optimization are highly regarded by both players and soccer coaches. Here, nutrition takes a special role as most elite teams try to provide an adequate diet to guarantee maximum performance while ensuring a faster recovery from matches and training exertions. It is currently known that manipulation and periodization of macronutrients, as well as sound hydration practices, have the potential to interfere with training adaptation and recovery. A careful monitoring of micronutrient status is also relevant to prevent undue fatigue and immune impairment secondary to a deficiency status. Furthermore, the sensible use of evidence-based dietary supplements may also play a role in soccer performance optimization. In this sense, several nutritional recommendations have been issued. This detailed and comprehensive review addresses the most relevant and up-to-date nutritional recommendations for elite soccer players, covering from macro and micronutrients to hydration and selected supplements in different contexts (daily requirements, pre, peri and post training/match and competition).

No Dose-Response Effect of Carbohydrate Mouth Rinse Concentration on 5-km Running Performance in Recreational Athletes

Clarke, ND, Thomas, JR, Kagka, M, Ramsbottom, R, and Delextrat, A. No dose-response effect of carbohydrate mouth rinse concentration on 5-km running performance in recreational athletes. J Strength Cond Res 31(3): 715-720, 2017-Oral carbohydrate rinsing has been demonstrated to provide beneficial effects on exercise performance of durations of up to 1 hour, albeit predominately in a laboratory setting. The aim of the present study was to investigate the effects of different concentrations of carbohydrate solution mouth rinse on 5-km running performance. Fifteen healthy men (n = 9; mean ± SD age; 42 ± 10 years; height, 177.6 ± 6.1 cm; body mass, 73.9 ± 8.9 kg) and women (n = 6; mean ± SD age, 43 ± 9 years; height, 166.5 ± 4.1 cm; body mass, 65.7 ± 6.8 kg) performed a 5-km running time trial on a track on 4 separate occasions. Immediately before starting the time trial and then after each 1 km, subjects rinsed 25 ml of 0, 3, 6, or 12% maltodextrin for 10 seconds. Mouth rinsing with 0, 3, 6, or 12% maltodextrin did not have a significant effect on the time to complete the time trial (0%, 26:34 ± 4:07 minutes:seconds; 3%, 27:17 ± 4:33 minutes:seconds; 6%, 27:05 ± 3:52 minutes:seconds; 12%, 26:47 ± 4.31 minutes:seconds; p = 0.071; (Equation is included in full-text article.)= 0.15), heart rate (p = 0.095; (Equation is included in full-text article.)= 0.16), rating of perceived exertion (p = 0.195; (Equation is included in full-text article.)= 0.11), blood glucose (p = 0.920; (Equation is included in full-text article.)= 0.01), and blood lactate concentration (p = 0.831; (Equation is included in full-text article.)= 0.02), with only nonsignificant trivial to small differences between concentrations. Results of this study suggest that carbohydrate mouth rinsing provides no ergogenic advantage over an acaloric placebo (0%) and that there is no dose-response relationship between carbohydrate solution concentration and 5-km track running performance.

Effect of mouth rinsing and ingestion of carbohydrate solutions on mood and perceptual responses during exercise

Background

The aim of this study was to investigate whether mouth rinsing or ingesting carbohydrate (CHO) solutions impact on perceptual responses during exercise.

Methods

Nine moderately trained male cyclists underwent a 90-min glycogen-reducing exercise, and consumed a low CHO meal, prior to completing an overnight fast. A 1-h cycle time trial was performed the following morning. Four trials, each separated by 7 days, were conducted in a randomized, counterbalanced study design: 15% CHO mouth rinse (CHOR), 7.5% CHO ingestion (CHOI), placebo mouth rinse (PLAR) and placebo ingestion (PLAI). Solution volumes (1.5 ml · kg⁻¹ ingestion trials and 0.33 ml · kg⁻¹ rinsing trials) were provided after every 12.5% of completed exercise. Perceptual scales were used to assess affective valence (feeling scale, FS), arousal (felt arousal scale, FAS), exertion (ratings of perceived exertion, RPE) and mood (profile of mood states, POMS) before, during and immediately after exercise.

Results

There was no difference in RPE (CHOI, 14.0 ± 1.9; CHOR, 14.2 ± 1.7; PLAI, 14.6 ± 1.8; PLAR, 14.6 ± 2.0; P = 0.35), FS (CHOI, 0.0 ± 1.7; CHOR, −0.2 ± 1.5; PLAI, −0.8 ± 1.4; PLAR, −0.8 ± 1.6; P = 0.15), or FAS (CHOI, 3.6 ± 1.1; CHOR, 3.5 ± 1.0; PLAI, 3.4 ± 1.4; PLAR, 3.3 ± 1.3; P = 0.725) scores between trials. While overall POMS score did not appear to differ between trials, the ‘vigour’ subscale indicated that CHOI may facilitate the maintenance of ‘vigour’ scores over time, in comparison to the steady decline witnessed in other trials (P = 0.04). There was no difference in time trial performance between trials (CHOI, 65.3 ± 4.8 min; CHOR, 68.4 ± 3.9 min; PLAI, 68.7 ± 5.3 min; PLAR, 68.3 ± 5.2 min; P = 0.21) but power output was higher in CHOI (231.0 ± 33.2 W) relative to other trials (221–223.6 W; P < 0.01).

Conclusions

In a CHO-reduced state, mouth rinsing with a CHO solution did not impact on perceptual responses during high-intensity exercise in trained cyclists and triathletes. On the other hand CHO ingestion improved perceived ratings of vigour and increased power output during exercise.

Timing, Optimal Dose and Intake Duration of Dietary Supplements with Evidence-Based Use in Sports Nutrition

[Purpose]

The aim of the present narrative review was to consider the evidence on the timing, optimal dose and intake duration of the main dietary supplements in sports nutrition, i.e. β-alanine, nitrate, caffeine, creatine, sodium bicarbonate, carbohydrate and protein.

[Methods]

This review article focuses on timing, optimal dose and intake duration of main dietary supplements in sports nutrition.

[Results]

This paper reviewed the evidence to determine the optimal time, efficacy doses and intake duration for sports supplements verified by scientific evidence that report a performance enhancing effect in both situation of laboratory and training settings.

[Conclusion]

Consumption of the supplements are usually suggested into 5 specific times, such as pre-exercise (nitrate, caffeine, sodium bicarbonate, carbohydrate and protein), during exercise (carbohydrate), post-exercise (creatine, carbohydrate, protein), meal time (β-alanine, creatine, sodium bicarbonate, nitrate, carbohydrate and protein), and before sleep (protein). In addition, the recommended dosing protocol for the supplements nitrate and β-alanine are fixed amounts irrespective of body weight, while dosing protocol for sodium bicarbonate, caffeine and creatine supplements are related to corrected body weight (mg/kg bw). Also, intake duration is suggested for creatine and β-alanine, being effective in chronic daily time < 2 weeks while caffeine, sodium bicarbonate are effective in acute daily time (1-3 hours). Plus, ingestion of nitrate supplement is required in both chronic daily time < 28 days and acute daily time (2- 2.5 h) prior exercise.

Thermal and Cardiovascular Strain Mitigate the Potential Benefit of Carbohydrate Mouth Rinse During Self-Paced Exercise in the Heat

Purpose: To determine whether a carbohydrate mouth rinse can alter self-paced exercise performance independently of a high degree of thermal and cardiovascular strain.

Methods: Eight endurance-trained males performed two 40-km cycling time trials in 35°C, 60% RH while swilling a 20-ml bolus of 6.5% maltodextrin (CHO) or a color- and taste-matched placebo (PLA) every 5 km. Heart rate, power output, rectal temperature (T_re), and mean skin temperature (T_sk) were recorded continuously; cardiac output, oxygen uptake (VO₂), mean arterial pressure (MAP), and perceived exertion (RPE) were measured every 10 min.

Results: Performance time and mean power output were similar between treatments, averaging 63.9 ± 3.2 and 64.3 ± 2.8 min, and 251 ± 23 and 242 ± 18 W in CHO and PLA, respectively. Power output, stroke volume, cardiac output, MAP, and VO₂ decreased during both trials, increasing slightly or remaining stable during a final 2-km end-spurt. T_re, T_sk, heart rate, and RPE increased throughout exercise similarly with both treatments. Changes in RPE correlated with those in T_re (P < 0.005) and heart rate (P < 0.001).

Conclusions: These findings suggest that carbohydrate mouth rinsing does not improve ~1-h time trial performance in hot-humid conditions, possibly due to a failure in down-regulating RPE, which may be influenced more by severe thermal and cardiovascular strain.

Re-Examining High-Fat Diets for Sports Performance: Did We Call the 'Nail in the Coffin' Too Soon?

During the period 1985-2005, studies examined the proposal that adaptation to a low-carbohydrate (<25 % energy), high-fat (>60 % energy) diet (LCHF) to increase muscle fat utilization during exercise could enhance performance in trained individuals by reducing reliance on muscle glycogen. As little as 5 days of training with LCHF retools the muscle to enhance fat-burning capacity with robust changes that persist despite acute strategies to restore carbohydrate availability (e.g., glycogen supercompensation, carbohydrate intake during exercise). Furthermore, a 2- to 3-week exposure to minimal carbohydrate (<20 g/day) intake achieves adaptation to high blood ketone concentrations. However, the failure to detect clear performance benefits during endurance/ultra-endurance protocols, combined with evidence of impaired performance of high-intensity exercise via a down-regulation of carbohydrate metabolism led this author to dismiss the use of such fat-adaptation strategies by competitive athletes in conventional sports. Recent re-emergence of interest in LCHF diets, coupled with anecdotes of improved performance by sportspeople who follow them, has created a need to re-examine the potential benefits of this eating style. Unfortunately, the absence of new data prevents a different conclusion from being made. Notwithstanding the outcomes of future research, there is a need for better recognition of current sports nutrition guidelines that promote an individualized and periodized approach to fuel availability during training, allowing the athlete to prepare for competition performance with metabolic flexibility and optimal utilization of all muscle substrates. Nevertheless, there may be a few scenarios where LCHF diets are of benefit, or at least are not detrimental, for sports performance.

Acute effects of dietary constituents on motor skill and cognitive performance in athletes

Performance in many sports is at least partially dependent on motor control, coordination, decision-making, and other cognitive tasks. This review summarizes available evidence about the ingestion of selected nutrients or isolated compounds (dietary constituents) and potential acute effects on motor skill and/or cognitive performance in athletes. Dietary constituents discussed include branched-chain amino acids, caffeine, carbohydrate, cocoa flavanols, Gingko biloba, ginseng, guarana, Rhodiola rosea, sage, L-theanine, theobromine, and tyrosine. Although this is not an exhaustive list, these are perhaps the most researched dietary constituents. Caffeine and carbohydrate have the greatest number of published reports supporting their ability to enhance acute motor skill and cognitive performance in athletes. At this time, there is insufficient published evidence to substantiate the use of any other dietary constituents to benefit sports-related motor skill or cognitive performance. The optimal dose and timing of caffeine and carbohydrate intake promoting enhanced motor skill and cognitive performance remain to be identified. Valid, reliable, and sensitive batteries of motor skills and cognitive tests should be developed for use in future efficacy studies.

The Governor has a sweet tooth - mouth sensing of nutrients to enhance sports performance

The oral-pharyngeal cavity and the gastrointestinal tract are richly endowed with receptors that respond to taste, temperature and to a wide range of specific nutrient and non-nutritive food components. Ingestion of carbohydrate-containing drinks has been shown to enhance endurance exercise performance, and these responses have been attributed to post-absorptive effects. It is increasingly recognised, though, that the response to ingested carbohydrate begins in the mouth via specific carbohydrate receptors and continues in the gut via the release of a range of hormones that influence substrate metabolism. Cold drinks can also enhance performance, especially in conditions of thermal stress, and part of the mechanism underlying this effect may be the response to cold fluids in the mouth. There is also some, albeit not entirely consistent, evidence for effects of caffeine, quinine, menthol and acetic acid on performance or other relevant effects. This review summarises current knowledge of responses to mouth sensing of temperature, carbohydrate and other food components, with the goal of assisting athletes to implement practical strategies that make best use of its effects. It also examines the evidence that oral intake of other nutrients or characteristics associated with food/fluid intake during exercise can enhance performance via communication between the mouth/gut and the brain.

Carbohydrate-dependent, exercise-induced gastrointestinal distress

Gastrointestinal (GI) problems are a common concern of athletes during intense exercise. Ultimately, these symptoms can impair performance and possibly prevent athletes from winning or even finishing a race. The main causes of GI problems during exercise are mechanical, ischemic and nutritional factors. Among the nutritional factors, a high intake of carbohydrate and hyperosmolar solutions increases GI problems. A number of nutritional manipulations have been proposed to minimize gastrointestinal symptoms, including the use of multiple transportable carbohydrates. This type of CHO intake increases the oxidation rates and can prevent the accumulation of carbohydrate in the intestine. Glucose (6%) or glucose plus fructose (8%–10%) beverages are recommended in order to increase CHO intake while avoiding the gastric emptying delay. Training the gut with high intake of CHO may increase absorption capacity and probably prevent GI distress. CHO mouth rinse may be a good strategy to enhance performance without using GI tract in exercises lasting less than an hour. Future strategies should be investigated comparing different CHO types, doses, and concentration in exercises with the same characteristics.